Phd in DYNAMIC AND CLINICAL PSYCHOLOGY

Thesis title: Processo ed esito di un intervento di counselling psicodinamico: verso una comprensione integrata dell’efficacia

In recent decades, the growing prevalence of psychological distress among university students has made counselling a crucial resource for promoting psychological well-being and supporting identity development during emerging adulthood. In light of this increasing demand for psychological support, it has become essential to understand whether and how university counselling interventions foster genuine processes of transformation and measurable improvements in students’ well-being, as well as which mechanisms account for their effectiveness. Grounded in a psychodynamic perspective, this thesis addresses two central questions: how to investigate the process and outcome of psychodynamic counselling, and how to assess its effectiveness through measures consistent with its transformative goals. The work integrates theoretical and methodological approaches from process–outcome psychotherapy research, focusing on common factors (such as therapeutic alliance and expectations) and on the constructs of mentalized affectivity and epistemic trust, considered potential mechanisms of psychological change. Three empirical studies were conducted at the University Counselling Service of Sapienza University of Rome. The first study validated the Italian version of the Expectations About Counseling – Brief Form (EAC-B), confirming its two-factor structure and excellent psychometric properties. Findings showed that higher expectations regarding personal commitment in counselling predicted a stronger therapeutic alliance and more positive outcomes. The second study examined the effectiveness of psychodynamic counselling in enhancing mentalized affectivity and reducing depressive symptoms, revealing significant improvements from pre- to post-intervention in both domains. The third study explored the combined role of epistemic trust and therapeutic alliance in predicting outcomes, identifying a moderating effect of alliance on the relationship between epistemic mistrust and outcome, and confirming sustained improvements in well-being at a three-month follow-up. Overall, the results demonstrate the effectiveness of psychodynamic counselling in fostering psychological well-being and self-awareness, highlighting how relational quality, epistemic trust, initial expectations, and the capacity to mentalize emotional states operate as key mechanisms underpinning its efficacy and transformative potential.